RN Comprehensive Predictor 2026
20 Original NCLEX-Style Practice Questions
With Detailed Answers, Rationales & Clinical Pearls
Question 1 of 20
Clinical Scenario
A 68-year-old woman is admitted with community-acquired
pneumonia. Her medical history includes hypertension,
osteoarthritis, and chronic kidney disease stage 3. The provider
prescribes an oral antibiotic to begin immediately. Before
administering the medication, the nurse reviews the electronic
health record and notes that the client has a documented
history of developing generalized hives and shortness of breath
after taking amoxicillin several years ago. Vital signs are stable,
and the client asks, "I've taken lots of medicines before. Does
this allergy really matter?"
Question Stem
Which nursing action is the priority before administering the
prescribed medication?
,Answer Choices
A. Administer the medication with food to decrease
gastrointestinal upset.
B. Verify the allergy history and notify the provider before
administering the medication.
C. Administer diphenhydramine before the antibiotic to prevent
an allergic reaction.
D. Delay the medication until renal function results are
available.
✓ Correct Answer: B. Verify the allergy history and notify the
provider before administering the medication.
Correct Answer & Rationale
A documented history of hives and shortness of breath
following amoxicillin suggests a previous immediate
hypersensitivity reaction that may progress to anaphylaxis if a
related medication is administered. The nurse's priority is to
verify the allergy details and notify the provider before giving
the medication. Medication safety begins with confirming
allergies before administration, especially when beta-lactam
antibiotics or medications with potential cross-reactivity are
involved. Preventing a serious adverse drug event takes
precedence over timely medication administration.
,Why the Other Options Are Incorrect
Option A is incorrect because administering medication with
food may reduce gastrointestinal irritation but does not reduce
the risk of an allergic reaction.
Option C is incorrect because premedicating with
diphenhydramine does not prevent anaphylaxis and should
never be used to justify administering a potentially
contraindicated medication.
Option D is less appropriate. Although renal function is
important when dosing many medications, preventing a
potentially life-threatening allergic reaction is the immediate
priority.
NCLEX Clinical Pearl: A documented history of hives and
shortness of breath following amoxicillin suggests a previous
immediate hypersensitivity reaction that may progress to
anaphylaxis if a related medication is administered. The nurse's
priority is to verify the allergy details and notify the provider
before giving the medication.
Key Nursing Concept: Medication Safety
Clinical Judgment Highlight: The priority is to prevent harm by
verifying an allergy before administering a medication that
could cause an anaphylactic reaction.
Safety Alert: Any history of hives and difficulty breathing after
, medication administration is a red flag for a severe allergy and
must be investigated before administering any related drug.
Learning Objectives
• Identify priority nursing actions before medication
administration.
• Recognize the significance of documented medication
allergies.
• Prioritize prevention of life-threatening adverse drug
reactions.
Question 2 of 20
Clinical Scenario
A 55-year-old man with newly diagnosed hypertension receives
a prescription for lisinopril. During discharge teaching, he
states, "If I start feeling better in a few weeks, I'll probably stop
taking it." His blood pressure today is 152/94 mm Hg. He denies
symptoms and has no evidence of target-organ damage.
Question Stem
Which response by the nurse is most appropriate?
Answer Choices
20 Original NCLEX-Style Practice Questions
With Detailed Answers, Rationales & Clinical Pearls
Question 1 of 20
Clinical Scenario
A 68-year-old woman is admitted with community-acquired
pneumonia. Her medical history includes hypertension,
osteoarthritis, and chronic kidney disease stage 3. The provider
prescribes an oral antibiotic to begin immediately. Before
administering the medication, the nurse reviews the electronic
health record and notes that the client has a documented
history of developing generalized hives and shortness of breath
after taking amoxicillin several years ago. Vital signs are stable,
and the client asks, "I've taken lots of medicines before. Does
this allergy really matter?"
Question Stem
Which nursing action is the priority before administering the
prescribed medication?
,Answer Choices
A. Administer the medication with food to decrease
gastrointestinal upset.
B. Verify the allergy history and notify the provider before
administering the medication.
C. Administer diphenhydramine before the antibiotic to prevent
an allergic reaction.
D. Delay the medication until renal function results are
available.
✓ Correct Answer: B. Verify the allergy history and notify the
provider before administering the medication.
Correct Answer & Rationale
A documented history of hives and shortness of breath
following amoxicillin suggests a previous immediate
hypersensitivity reaction that may progress to anaphylaxis if a
related medication is administered. The nurse's priority is to
verify the allergy details and notify the provider before giving
the medication. Medication safety begins with confirming
allergies before administration, especially when beta-lactam
antibiotics or medications with potential cross-reactivity are
involved. Preventing a serious adverse drug event takes
precedence over timely medication administration.
,Why the Other Options Are Incorrect
Option A is incorrect because administering medication with
food may reduce gastrointestinal irritation but does not reduce
the risk of an allergic reaction.
Option C is incorrect because premedicating with
diphenhydramine does not prevent anaphylaxis and should
never be used to justify administering a potentially
contraindicated medication.
Option D is less appropriate. Although renal function is
important when dosing many medications, preventing a
potentially life-threatening allergic reaction is the immediate
priority.
NCLEX Clinical Pearl: A documented history of hives and
shortness of breath following amoxicillin suggests a previous
immediate hypersensitivity reaction that may progress to
anaphylaxis if a related medication is administered. The nurse's
priority is to verify the allergy details and notify the provider
before giving the medication.
Key Nursing Concept: Medication Safety
Clinical Judgment Highlight: The priority is to prevent harm by
verifying an allergy before administering a medication that
could cause an anaphylactic reaction.
Safety Alert: Any history of hives and difficulty breathing after
, medication administration is a red flag for a severe allergy and
must be investigated before administering any related drug.
Learning Objectives
• Identify priority nursing actions before medication
administration.
• Recognize the significance of documented medication
allergies.
• Prioritize prevention of life-threatening adverse drug
reactions.
Question 2 of 20
Clinical Scenario
A 55-year-old man with newly diagnosed hypertension receives
a prescription for lisinopril. During discharge teaching, he
states, "If I start feeling better in a few weeks, I'll probably stop
taking it." His blood pressure today is 152/94 mm Hg. He denies
symptoms and has no evidence of target-organ damage.
Question Stem
Which response by the nurse is most appropriate?
Answer Choices
